Ever heard of symphysiotomy? Probably not; my spell check doesn’t even know what it is. But it’s a painful surgical procedure which involves breaking a woman’s pelvis during childbirth that sounds like an ancient torture method but was once an alternative to Caesareans used in maternity hospitals across Ireland in the 20th century.

When members of the Survivors of Symphysiotomy (SOS) met in Dublin yesterday, they were able to recognize each other thanks to the “signature limp” survivors have. (Other less visible related problems include chronic back pain and incontinence.) Group members, many of whom are in their 70s and 80s, say that the operations were carried out without the women’s consent “mainly for religious reasons, by obstetricians who were opposed to family planning.” Huh; sounds horrifingly familiar.

Symphysiotomy is associated with poor maternal health, for two principal reasons. The first relates to the main indication for the procedure: disproportion and/or contracted pelvis. Contracted pelvis was relatively common in nutritionally deprived mothers, who had not achieved full growth before pregnancy. It was frequently described in Britain in the pre and immediate post-war years, and was specifically associated with inner-city populations.103
In Ireland, it was common amongst inner city mothers in Dublin, Belfast, Cork and Limerick, but also throughout rural areas. The economic situation of many Irish families was dire: the 2009 Commission to Inquire into Child Abuse provides shocking detail regarding the deprivation faced by many Irish families because of poor wages and unemployment 104 . Mothers and children felt the full impact of poor diet, with women in particular suffering from chronic illness associated with inadequate nutrition. They also presented in labour with complications that made them poor candidates for general anaesthetic (anaemic, with heart disease, tubercular), and ensured that symphysiotomy was considered a safer alternative to caesarean section in the 1940s and 1950s.

If one knows a little history, it is not difficult to understand why we have “welfare” programs devoted to women and children AND why it is so important to continue funding these programs. Those who don’t know are easily swayed by those who want to determine the morality for the rest of us.

. The Censorship of Publications Act of 1929 eliminated published material that offered information on the avoidance of pregnancy by banning any material that was deemed to ‘advocate the unnatural prevention of contraception or the procurement of abortion or miscarriage.’ Indeed, much of the emphasis of the Act, and the evidence presented to the ‘Committee on Evil Literature’ that shaped its parameters, concerned birth control and the prevention of conception. 40 The sale of artificial contraceptives were banned under the 1935 Criminal Law Amendment Act: any doctor offering such material, and even information on it, was liable to prosecution.41

Religion and Irish Obstetrics:
Irish obstetrical practice was heavily influenced by, and constrained within, a widely accepted religious framework. This influence was not merely ideological, but also shaped legislation in order to ensure conformity to certain religious principles. The dominance of the church in almost all areas of Irish life was also felt within medicine, and in the period of this study the pernicious influence of the Catholic Archbishop of Dublin, Charles John McQuaid, spread far beyond the capital. His interference to their detriment in the broader realm of women’s general health reflected a preoccupation with largely illusory battles regarding morals, ensuring that malnourished and exhausted mothers produced children whom they could not afford to feed, clean, or clothe. McQuaid, in common with the rest of the Church hierarchy, did indeed believe that ‘the issue of maternity care was a religious one.’36 An unyielding belief system that would not countenance artificial contraception or sterilisation for the prevention of pregnancy also placed legal restrictions upon medical practitioners, and put them into a very different position from their European peers. Many found the position intolerable. The testimony of obstetricians, and the memoirs of other practitioners, indicate how many medics struggled to provide the care their patients needed, while constrained by a conservative medical and social structure. 37

Symphysiotomy was initially performed in France in 1777, resulting in delivery of a living infant from a dwarfed mother after four previous stillbirths. Maternal morbidity was considerable and the operation did not enjoy great renown. In the late 1800s when cephalopelvic disproportion became an increasing problem due to a resurgence of maternal rickets,symphysiotomy enjoyed a revival. Particularly well accepted in Catholic countries where it preserved future child bearing that a cesarean section would not, it lost favor in Protestant countries where this was less of a concern. In 1914, the method that is used today (with several variations) of subcutaneous symphysiotomy was developed. By the turn of the twentieth century, nutritional status had improved and symphysiotomy was no longer in great need except in areas where social reform lagged or religious beliefs promoted grand multiparity. It fell into disfavor as cesarean section methods and outcomes improved with the development of antibiotics, anesthesia and blood replacement therapy and is today primarily performed in developing nations as an alternative to cesarean section. An important question to ask is, “does symphysiotomy have a place in modern obstetric practice?” (14). This paper will present data to consider in this debate.

This article also indicated the procedure is used in 3rd World countries mostly because maternal health can be so poor. The concern being that a C-Section presents more risk.

Symphysiotomy is a procedure used on women in developing nations to vaginally deliver babies in cases of moderate cephalopelvic disproportion where cesarean section is either unavailable or inadvisable. It is not considered standard of care in the United States. The literature suggests that US doctors are biased against the procedure citing risks of bladder, urethral, and joint injury, long-term morbidity including urinary incontinence and unstable gait when weighed against the availability of safe and immediate cesarean section in this country. There are few studies regarding the efficacy and safety of symphysiotomy and many of them are not well controlled but the available literature does suggest that this technique has as good or better outcomes when compared with cesarean section.

As usual, it is poor and disadvantaged women and their children who suffer in this world. Yet providing funds to ease this horror is “only serving to loosen morals and pay sluts to have sex”, to paraphrase a few of the Pundits we hear from.

People are going to have sex and have babies regardless of anyone’s views on morality. What is immoral is not to do what we can to care for the children that are already hear and to prevent the conditions that lead to these horrors.

This is incredible. I have been in this field for almost 30 years and always believed this was a procedure performed in rural areas of 3rd world countries where c-sections were not an option. This is an incredibly barbaric procedure and I am amazed it was performed so recently in Ireland. It speaks volumes about these peoples' opinion of women that this would be preferable to an operation that "might" result in a woman to have fewer children in the end.

I guess the "Intelligent Design" god that made us could not figure out how to make women have babies without breaking their pelvises in some cases.

Or maybe he planned it that way for the lulz because the Abrahamic god reads as a mother*&&^ insane god, if it is real. I recall it is religious dogma that women have to hurt in child birth as reminders of Eve's original sin.

In 1846 James Simpson, a Scottish physician promoted the use of chloroform to relieve pain during childbirth. This was opposed by the Church, citing Genesis 3:16 "...I will greatly multiply thy sorrow and thy conception; in sorrow thou shalt bring forth children". The avoidance of pain was seen as thwarting God's will.

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